Tigh Fruin

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires Improvement. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice. The registered manager had developed a positive culture and had effective oversight of the service which meant there was an embedded learning culture at Tigh Fruin. A continuous improvement plan was in place which demonstrated areas for improvement were actioned without delay to improve the safety of the service. This proactive approach decreased the risk of issues reoccurring, thereby protecting people from the risk of harm.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. All people had a holistic assessment of their individual needs and aspirations prior to moving into Tigh Fruin. A relative we spoke with said, “The transition for my [relative] was very good, a 10-week period to build them up to moving in.” Care plans and risk assessments were in place for people and detailed individual risks. For example, a person who required specific support regarding managing periods of distress, had a detailed support plan in place. This meant staff had accurate information to support people safely. We also found where people needed specialist support, advice was sought without delay. For example, we found where a person required specific support with their medicines, detailed guidance was sought to ensure staff supported the person safely. This meant people received support in a timely manner.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. Staff and the registered manager were fully aware of their safeguarding responsibilities to ensure people were protected from abuse and neglect. People, their safety and rights were at the heart of the service. Each person had a detailed safeguarding support plan in place to ensure they lived their lives in their chosen way, with support from staff using the least restrictive approach. A relative we spoke with said, “I am very confident my [relative] is safe.” Staff completed training which enabled them to identify and act on safeguarding concerns. The registered manager reported concerns to the local authority safeguarding team without delay, they ensured timely reviews took place to protect people from any future risks. A consistent safeguarding process meant the service prioritised people’s human rights and safety.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service and found where needed people had DoLS authorisations in place.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them. People were supported to take positive risks to ensure they lived fulfilled lives. A relative we spoke with said, “My [relative] has no risk awareness, they can’t cross the road safely, but the staff keep them safe and work with them to understand road safety.” Staff supported people in line with their assessed needs. Care and support plans detailed people’s needs with clear guidance in how staff should support them. For example, people had detailed person-centred positive behaviour support plans in place. These plans clearly detailed techniques for staff to support each person. This meant staff had accurate information in how they should support people to minimise periods of distress.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The environment was well maintained, designed and adapted to meet the needs of people living at Tigh Fruin. Each person’s needs and culture were considered when designing the lounges, pictures of each person’s heritage and background were displayed in the home. This promoted a safe environment where people were encouraged and supported to be their whole selves. The provider ensured the environment was maintained to keep people safe from harm. For example, the monitoring of water temperatures to ensure they did not pose a scalding risk to people was consistently completed. Tigh Fruin was safe in the event of a fire, all people had personal emergency evacuation plans in place in the event of an emergency.The registered manager ensured fire evacuation drills were carried out regularly to ensure people and staff knew what action to take in the event of a fire. The aim of regular fire drills was to empower and educate people using the service and reduce any potential distress people may experience in the event of an emergency.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

Staff were exceptionally well trained in understanding each individual person’s needs. Staff told us, they were supported exceptionally well by the management team. A staff member told us, “I am really supported to develop, I’m being supported to progress in my career,” and a senior leader told us, “We have a structured competency framework, there is genuine career progression.”

There were always enough staff to ensure people lived their lives safely and free from unnecessary restrictions, staff were matched to people’s specific needs and wishes. The registered manager explained, they spent time getting to know people and recruited staff in line with people’s individual needs. For example, a person living at the service responded and engaged better with male staff, the registered manager ensured male staff were available for the person. People were relaxed and happy in staffs’ company. We spent time observing staff, people and their interactions, as they either did not want to speak to us or were unable to verbally communicate with us. Relatives told us staff knew their loved ones, with a relative commenting, “Staff know exactly what works for [relative].”

Recruitment processes were followed to ensure only suitable staff were appointed. Checks including, interviews, references and Disclosure and Barring Service (DBS) checks were conducted before staff started working at the service. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The home was clean and tidy; people were encouraged to increase their independence and were supported to maintain cleanliness in their own bedrooms. People’s bedrooms and bathrooms were clean, personalised and homely. A relative we spoke with told us, “The home is exceptionally clean, hotel standard.” Infection prevention and control audits ensured any issues were addressed and rectified without delay, this protected people from the risk of harm.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff received training in medicines and had their competency assessed. People had detailed individual medicine care plans in place to guide staff what support each person required. People were supported to understand what medicines were, staff used pictures and props such as empty medicine boxes to inform people and assess their understanding. This support empowered and educated people living at the service to gain a greater understanding of their prescribed medicines. The service implemented best practice guidance to ensure people did not receive medicines unnecessarily. The STOMP (Stopping Over Medication of People with a Learning Disability, Autism or both) initiative was embedded at the service. Staff demonstrated excellent knowledge around this guidance. The registered manager explained, “One of the people we support was regularly receiving a sedative medicine before they moved here, I’m proud to say they no longer need any medicines like that, and they are happy and thriving.” The implementation of this initiative protects people from being over medicated and has improved the quality of life of people living at the service.